2019 Volume 47 Issue 6 Pages 456-460
A 66-year-old man referred to our department had presented with progressive myelopathy for over 2 years. A high-signal-intensity lesion was seen at the cervical spinal cord on T2-weighted magnetic resonance imaging (MRI). Cerebral angiography demonstrated a dural arteriovenous fistula (DAVF) at the craniocervical junction (CCJ), which was fed by the ascending pharyngeal artery and drained into the cervical perimedullary veins. A right suboccipital craniotomy was performed. Dural opening disclosed an abnormally dilated vein posterior to the jugular foramen. The draining vein was surgically coagulated. After surgery, the patient’s symptom subsided. Post-operative cerebral angiography confirmed the complete obliteration of the fistula. On MRI, the abnormal signal of the cervical cord markedly improved. We discuss the surgical strategies for CCJ-DAVF.
